iqtsupport, Author at DeBrunner & Associates

Non-Profit Hospitals Tout Community Benefit

Non-profit hospitals invest $11 for every one dollar they do not pay in taxes because of their tax-exempt status. Or so says a study prepared for the American Hospital Association. According to the study, in 2013 non-profit hospitals provided $67.4 billion worth of benefits to their communities compared to the $6 billion they would have paid in taxes had they been for-profit hospitals. Those community benefits came in four forms: financial assistance and means-tested government programs (such as unreimbursed Medicaid costs) community-building activities Medicare shortfalls bad debt attributable to charity care Learn more about what the study found and how [...]

iqtsupport2017-10-13T06:00:32-04:00October 13, 2017|Uncategorized|

Pay Issues Slow Telehealth Spread

While most health care organizations and providers intend to make greater use of telehealth in the coming years, the manner and speed with which that use grows is being limited in part by reimbursement issues. A survey conducted for the College of Healthcare Information Management Executives found that About half of the study respondents listed reimbursement as a limitation, noting that some payers have been slow to reimburse telehealth visits and or reimburse at rates that are lower than face-to-face care. Survey participants reported using telehealth in three primary ways: scheduled patient “visit,” on-demand urgent needs, and specialist consultations. Learn [...]

iqtsupport2017-10-12T06:00:27-04:00October 12, 2017|Uncategorized|

MedPAC Meets

The independent agency that advises Congress and the administration on Medicare payment policies met last week in Washington, D.C. Among the issues discussed at the meeting of the Medicare Payment Advisory Commission were: the merit-based incentive payment system a unified payment system for post-acute care telehealth a redesign of Medicare’s hospital value incentive program Find the presentations and issue briefs for these subjects and others discussed at the MedPAC meeting here, on MedPAC’s web site.

iqtsupport2017-10-11T06:00:23-04:00October 11, 2017|Medicare, MedPAC|

House Committee to Hold 340B Hearing

The House Energy and Commerce Committee’s oversight subcommittee will hold a hearing on Wednesday about the 340B Drug Pricing Program. At the hearing, titled “Examining How Covered Entities Utilize the 340B Drug Pricing Program,” the subcommittee hopes …to hear directly from entities participating in the program to get a better understanding of how the program is used, including how much money is saved, the types of drugs purchased and prescribed within the program, how entities track their savings, and how those savings are used to improve patient care. Learn more about the hearing and the witness list from the subcommittee’s [...]

iqtsupport2017-10-10T06:00:39-04:00October 10, 2017|Medicare|

340B Changes Would Hurt Hospital Margins

Proposed changes in the federal section 340B prescription drug discount program would hurt hospital margins. So says Moody’s Investors Service, the credit rating agency. According to Moody’s, the margins of non-profit hospitals are already under pressure because revenue increases are not keeping pace with prescription drug costs. Reductions of payments under the 340B program recently proposed by the Centers for Medicare & Medicaid Services would make a challenging situation worse, Moody’s speculates. Under the 340B program, eligible hospitals purchase prescription drugs at a discount, supply them to eligible outpatients, and use the savings they gain to provide additional services and [...]

iqtsupport2017-10-09T06:00:51-04:00October 9, 2017|Medicare, Medicare cuts, Medicare regulations|

Suit Claims Low Medicaid Rates are Discriminatory

A lawsuit filed in state courts in California argues that the state’s low Medicaid payments amount to discrimination against the state’s large Hispanic Medicaid population. California pays among the lowest rates in the country to physicians, making health care inaccessible for some, and the suit maintains that this is a civil rights issue in which low rates amount to discrimination. The suit is based on state anti-discrimination and equal protection laws, and many other states have similar laws on the books. Observers question whether the low rates constitute discrimination against the suit’s Hispanic plaintiffs because the low rates affect the [...]

iqtsupport2017-10-03T10:00:05-04:00October 3, 2017|Medicaid|

House Committee Looks at 340B

Are hospitals using the savings generated by their participation in the section 340B prescription drug discount program to help their low-income and uninsured patients? That’s what the House Energy and Commerce Committee’s Health Subcommittee is asking. Earlier this year the committee requested such information from the Health Services and Resources Administration, which runs the 340B program, and now it’s asking hospitals as well. Specifically, the subcommittee sent five-page letters to 19 providers that participate in the 340B program asking them about: the quantity of 340B-purchased drugs they dispense to Medicare beneficiaries, Medicaid beneficiaries, and those with private insurance the quantity [...]

iqtsupport2017-09-22T06:00:55-04:00September 22, 2017|hospitals|

GAO: Improvement Needed in MLTSS Oversight

The Centers for Medicare & Medicaid Services needs to improve the job it does overseeing state Medicaid programs of managed long-term services and supports. According to a new report by the U.S. Government Accountability Office, 22 states use MLTSS programs to help qualified seniors continue living independently in the community and to save money on nursing home costs. CMS’s oversight of these efforts, and of the use of federal funds, is inconsistent and often falls short when monitoring key considerations such as provider network adequacy, critical incidents, and appeals and grievances. To address these concerns, the GAO recommends that CMS [...]

iqtsupport2017-09-21T06:00:37-04:00September 21, 2017|Medicaid, Medicaid long-term services and supports|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met recently in Washington, D.C. Among the issues MACPAC commissioners discussed during their two-day meeting were: delivery system reform incentive payment programs Medicaid enrollment and renewal processes managed care oversight monitoring and evaluating section 11115 demonstration waivers Medicaid coverage of telemedicine services MACPAC advises the administration, Congress, and the states on Medicaid and CHIP issues. It is a non-partisan agency of the legislative branch of government. Go here to find background information on these and other subjects as well as links to the presentations that MACPAC staff made to the commissioners during [...]

iqtsupport2017-09-20T06:00:11-04:00September 20, 2017|MACPAC, Medicaid, Medicaid managed care, Medicaid regulations|

What is a Hospital?

The Centers for Medicare & Medicaid Services has taken a step toward answering that question in a new, 12-page guidance document that seeks to define whether a facility qualifies as a hospital under section 1861(e) of the Social Security Act. At the heart of the question is that law’s definition of a hospital, which includes that it is “primarily engaged” in caring for inpatients. CMS’s guidance outlines parameters for determining whether a hospital meets this standard. Find that CMS document here.

iqtsupport2017-09-19T06:00:12-04:00September 19, 2017|hospitals|

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